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Individual

ANNA BETH PORTRUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARM D

Contact information

Practice address
1035 S CUMBERLAND ST, MORRISTOWN, TN 37813-5236
(423) 586-6271
Mailing address
1123 CASTILE AVE, MORRISTOWN, TN 37814-3465
(423) 586-4562

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8265
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1831272129
PHARMACY IDENTIFIER
TN
Enumeration date
01/18/2007
Last updated
07/08/2007
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